<?php $this->load->view('layout/header'); ?>
<form method="post" target="_self">
<table class="fieldset">
    <tr class="fieldset">
        <td class="fieldset">
            <fieldset id="form"><legend accesskey="N" tabindex="1"><?=$title?></legend>
                <table><tr>
                    <th><label for="org">Organization Name</label></th>
                </tr><tr>
                    <td><input type="text" name="Name" value="<?=$Name?>" size="30" maxlength="50" /></td>
                </tr><tr>
                    <th><label for="org">Organization Type</label></th>
                </tr><tr>
                    <td><?=$org_type_select?></td>
                </tr><tr>
                    <th><label for="Street">Street</label></th>
                </tr><tr>
                    <td><input type="text" name="Street" value="<?=$Street?>" size="30" /></td>
                </tr></table>                <table><tr>
                    <th><label for="Postcode">Zip/Postcode</label></th>
                    <th><label for="country">Country</label></th>
                </tr><tr>
                    <td><input id="Postcode" type="text" name="Postcode" value="<?=$Postcode?>" size="5" maxlength="15" /></td>
                    <td><?=$country_select?></td>
                </tr></table>
                <table><tr>
                    <th><label for="Phone">Phone</label></th>
                    <th><label for="Phone">FAX</label></th>
                </tr><tr>
                    <td><input type="text" name="Phone" value="<?=$Phone?>" size="12" maxlength="15" /></td>
                    <td><input type="text" name="FAX" value="<?=$FAX?>" size="12" maxlength="15" /></td>
                </tr></table>
                <table><tr>
                    <th style="text-align:right;"><label for="website">Website</label></th>
                    <td><input type="text" name="Website" value="<?=$Website?>" size="30" /></td>
                </tr></table><br />
                <input class="right" type="submit" name="submit_org" value="Submit" />
        </fieldset>
    </td></tr></table>
</form>
<?php $this->load->view('layout/footer'); ?>
